MANAGEMENT OF SUPERFICIAL G2 (pTa AND pT1) BLADDER CANCER A. C. THORPE, ER.C.S.(E) B. J. JENKINS, F.R.C.S. J. E. MARTIN, M.A., M.B. From the Departments of Urology and Pathology, The London Hospital, Whitechapel, London, England )tal of 143 patients with superficial G2 (pTa, pT1) bladder cancer (48 G2pTa; 95 ~, between 1970 through 1987 were reviewed. 0f48 patients with G2p Tafollowed years, G3 recurrence developed only in 1 (2.0 %), and invasive cancer ( >p T2) 2 (4.2%). They both received radiotherapy and have responded completely. no cancer-related deaths. In contrast, in the 95 patients in whom the basement ~en breached (pT1), higher grade tumor (G3) developed in 11 (11.5 %), and 15 znces with invasion of muscle (>pT2). Among these there were 7 (7.3 %) cancer- bladder tumors (pTa, pT1 veil-differentiated (GI) and it ~ral experience that they are transurethral resection and ten appropriate, by intravesi- or Bacillus Calmette-Gu6rin :this, for a time, it came to be ~rficial tumors were safe, and ~d in terms of prognosis was ban the grade of the tumor, ell recognized that within the '.ial tumors there were sub- )t do so well, notably poorly ',3) tumors ~-s and those in nent membrane had been .6 ent while transurethral resec- cal chemotherapy continued , of treatment for G1 superfi- ~on came to regard the super- being so dangerous that they they were invasive, i.e., with py backed up by salvage cys- that appears to be vindicated There remained the intermediate group of tumors of G2 grade. It is common experience that from time to time they progress in an unex- pectedly bad way. They are relatively uncom- mon: little has been published about their natu- ral history, and there is no consensus as to how best they should be treated. Increasingly we be- came concerned that perhaps our treatment was insufficiently radical. For this reason we decided to review our experienee of patients with superficial (G2pTa, pT1) tumors. Material and Methods Between 1970 and 1987 inclusive, 178 pa- tients had been referred to this department with G2 superficial tumors (pTa,pT1). Thirty- five were lost to follow-up, and this report is based on 143 patients who have been followed up from one to seventeen years (mean follow-up 57.5 months: range 12-208 months). M1 tumors were graded in accordance with the interna- tional histologic classification of bladder tu- mors, as specified by the World Health Organi- zation. 8 tiBER 1990 / VOLUME XXXVI, NUMBER 5 395